Title: Holographic Imaging/Mixed Reality in Degenerative Mitral Disease: a New Tool for a Better Understanding and Planning Operations in Complex Multi-scallops Prolapse ?
Presented During:
Friday, May 5, 2023: 7:30AM - 7:35AM
New York Hilton Midtown
Posted Room Name:
Petit Trianon
Abstract No:
MO062
Submission Type:
Abstract Submission
Authors:
marco diena (1), Samuel Mancuso (2), Massimo Chessa (3), Giorgio Cerin (4)
Institutions:
(1) IRCCS Policlinico San Donato. Milan, Italy, (2) IRCCS Policlinico San Donato, Milan, NA, (3) IRCCS Policlinico San Donato., Milan, NA, (4) The Cardioteam Foundation, Torino, NA
Submitting Author:
marco diena
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IRCCS Policlinico San Donato. Milan
IRCCS Policlinico San Donato. Milan
Co-Author(s):
Samuel Mancuso
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IRCCS Policlinico San Donato
IRCCS Policlinico San Donato
Massimo Chessa
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IRCCS Policlinico San Donato.
IRCCS Policlinico San Donato.
Giorgio Cerin
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The Cardioteam Foundation
The Cardioteam Foundation
Presenting Author:
marco diena
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Abstract:
Objective: Mitral valve repair is the operation of choice in degenerative disease but the actual repair rate is about 70% of cases only. The main reason is the difficulty in understanding the exact anatomy in prolapse involving multi scallops as in Barlow. Transesophageal echo (TOE) depend on sonographer and surgeon's experiences and images limited on a 2D screen. The aim of this study was to evaluate the feasibility of an Holographic Imaging/Mixed Reality (HIMR) reconstruction from CT scan and if this technology may give a better perception of the real complex mitral anatomy and the surrounding structures.
Methods: Preliminarily we evaluated the feasibility of assessing the pre-operative MV anatomy of patients using HIMR technology starting from a 256 slices CT scan. Patients undergoing MV surgery with multi-segment prolapse underwent a dynamic ECG-gated contrast enhanced CT scan. Acquired clinical images were used as an input for a new created software building a 3D patient-specific holographic reconstructions in 34 cases. Than 10 cardiac surgeons from our staff were asked to compare the HIMR imaging with the corresponding 3D intraoperative TOE by a questionnaire.
Results: The dynamic HIMR was successful reconstructed in 94% of the cases from complex degenerative mitral valve CT scan. In a subjective non quantitive evaluation all the surgeons (n 10) have confirmed a better visualization of the prolapsing scallops in HIMR mode with higher anatomical spatial definition in systole and diastole. From an objective point of view all surgeons could explored the surrounding structure : the subvalvular apparatus ( papillary muscles), the LV outflow tract and Cx artery in a real 3D mode, from different planes and perspectives ( not possible with TOE).
Conclusion: This software provided an intuitive way to fully appreciate the complex MV morphology and dynamics. Objective advantages of HIMR compared to TOE is the enhanced visualization of the valve and surrounding structures in a real 3D mode. Surgeons have the possibility to navigate into the true anatomy through a direct interaction by dynamic holograms providing a real perception of depth and spatial relationships. HIMR has the disadvantage not to be a real time technology but it is a promising new tool for surgeons and cardiologists in undertstanding and planning repair on complex mitral valve cases. Further studies are necessary to prove the real clinical advantage of this new exciting technology.
Methods: Preliminarily we evaluated the feasibility of assessing the pre-operative MV anatomy of patients using HIMR technology starting from a 256 slices CT scan. Patients undergoing MV surgery with multi-segment prolapse underwent a dynamic ECG-gated contrast enhanced CT scan. Acquired clinical images were used as an input for a new created software building a 3D patient-specific holographic reconstructions in 34 cases. Than 10 cardiac surgeons from our staff were asked to compare the HIMR imaging with the corresponding 3D intraoperative TOE by a questionnaire.
Results: The dynamic HIMR was successful reconstructed in 94% of the cases from complex degenerative mitral valve CT scan. In a subjective non quantitive evaluation all the surgeons (n 10) have confirmed a better visualization of the prolapsing scallops in HIMR mode with higher anatomical spatial definition in systole and diastole. From an objective point of view all surgeons could explored the surrounding structure : the subvalvular apparatus ( papillary muscles), the LV outflow tract and Cx artery in a real 3D mode, from different planes and perspectives ( not possible with TOE).
Conclusion: This software provided an intuitive way to fully appreciate the complex MV morphology and dynamics. Objective advantages of HIMR compared to TOE is the enhanced visualization of the valve and surrounding structures in a real 3D mode. Surgeons have the possibility to navigate into the true anatomy through a direct interaction by dynamic holograms providing a real perception of depth and spatial relationships. HIMR has the disadvantage not to be a real time technology but it is a promising new tool for surgeons and cardiologists in undertstanding and planning repair on complex mitral valve cases. Further studies are necessary to prove the real clinical advantage of this new exciting technology.
Mitral Conclave:
From Bench to Bedside: Mitral Valve Research
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